Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 36432 | NC |
N | 2086S0127X | Trauma Surgeon | L2663 | TX |
Y | 2086X0206X | Surgical Oncologist | L2663 | TX |
NPI | 1154355626 |
---|---|
Provider Name | Dr. David Lawrence Smith |
First Address | Plano, TX 75093-5848 |
Second Address | Plano, TX 75093-5848 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 11/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F56624 | (02) | TX |